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14230 SW HALL BLVD f N W O z x r C' tti r d 14230 SW HALL BOULEVARD CITYOF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM1999-00411 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/07/1999 PARCEL: 2511?_f3B 03500 SITE ADDRESS: 14230 SW HALT_ BLVD SUBDIVISION: WILSON ACRES ZONING: R-7 BLOCK: LOT: 003 _ JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS. 1 CAI CH BASINS: _ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of a gas water heater. FEES Owner: _ Type By Date Amount Receipt WILSON BAISA, &TRACY YPRMT GEO 12/07/199 $50.00 99-320240 14230 SW HALL BLVDEx�rR�' 5PCT GEO 12/07/199`` $4.00 99-320240 TIGARD, OR 97223 Total $54.00 Phone 1: 7/ Contractor: r- A-OK HEATING& AIR CONDITIONIN 19649 NW COLLINS RD NORTH PLAINS, OR 97133 REQUIRED INSPECTIONS Phone 1: 503-647-5531 Misc. Inspection Final Inspection Reg #: LIC 105729 PLM 34-293PB ORIGINAL This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be dune in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. AT Oregon law requires you to follow rules adopted by the Oregon Utility Notification Certer. Those rules are set forth in OAR 952-0001-0010 through OAR 952_-0001-0080. You may obtain copies.of these rules-or direct questions to OUNC by calling (503) 2.46-1987. j, Permittee Signature: Issued By- / g `=s : Call (503 639-4175 by 7:00 P.M. for an inspection needed the next busihs"d e' CITY,OF TIGARD Plumbing Permit Application Plan Chock# 13125 SW HALL BLVD. Commercial and Residential Recd By _ TIGARD, OR 97223 Date Recd_ _- (503) 639-4171 Date to P.E. - Print or Type Date to DST_ Incomplete or illegible applications will not be accepted Permit#®GA1iti49-�by// Related SWR# Called Name of DevelopmentJProiect FIXTURES (individual) QTY PRICE AMT Job I-( 2-3o qh-o - 13L✓D Sink 11.50 Address Street Address Suite Lavatory 11.50 Tub or Tub/Shower Comb. _ 11.50 Bldg# Cit /State ZIPShower Only 11.50 _ � Dl7 �17zZ3 Water Cluset/UrInall Name (Specify) 11.50 W I(,,5p Aj ( Dishwasher 11.50 Owner MIlin Address Suite Urinal 11.50 :�k)ffAt Garbage Disposal 11.50 Cit //SSttarattteZip Phone Laundry Tray 11.50 0k c7u Name Washing Machine/LaundryTray (Specify) 11.50 5 P71jrLT Ip '- Floor Drain/Floor Sink 2" 11.50 � Occupant Mailing Address Suite 3" 11.50 City/Slate Zip Phone 4" 11.50_ Water Heater Xconverslon O like kind ' 11.50 Mame Gas piping requires a separate mechanical permit. f"f _O e- ' /� MFG Home New Water Service 28.00 Contractorddress Suite MFG Home Now San/Storm Sewer 28.00 ,(/GJ CUt-qA6,e© Hose Bibs 11.50 Prior to permit ittoa -Lip Phone Roof Drains 11.50 issuance,a copy PL--4146 7/-33 4PV7-5S31, Drinking Fountain 11.50 of^.,I licenses are Oregon Const Cont.Board Llc.# Exp Da required If A( Other Fixtures(Specify) �i 15.00 expired In COT Plumbin Ic #� Date database Name ` '-a� q-7) 7 -- Arch itect Sewer-1 at 100' 38.00 or Mailing Address Suite Sewer-each additional 100' 32.00 City/State Zip Phone Water Service-1 at 100' 38.00 Engineer Water Service-each additional 200' 32.00 Describe work to be done: Storm&Rain Drain-1 at 100' 38.00 New 1*' Repair O Replace with like kind: Yes O No O Storm&Rain Drain-each additional 100' 32.00 Residential Commercial O Additional description of work. Commercial Back Flow Prevention Device 32.00 Residential Backflow Prevention Device' 1900. _ Catch Basin 11.50 Ane you capping,moving or replacing any fixtures? Insp.of Existing Plumbing or Specially Requested 50.00 Yes W No O Inspections perthr If yes,see back of form to indicate work performed by Rain Drain,single family dwelling 45.00 fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50 WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL I hereby acknowledge that I have read this application,that the information Isometric or riser diagram Is required If Quantic Total is >9 given Is correct,that I am the owner or aulhudzed agent of the owner,and g q y that plans submitted are In compliance with Oro State Laws. "SUBTOTAL Slgnstttygot Owns gont Ditto �- 99 8%SURCHARGE Contact Person Name 71-7 hgn _ S 17}Y _ (p _cJ- -13-3 "PLAN REVIEW 26%OF SUBTOTAL -�1 HATH HOUSE$178.00 Required onlyM fixture t totalis>9 -- - ��•� 2 BATH HOUSE$250.00 TOTAL 7ct 3 BATH HOUSE$285.00 - -- This fee Includes all lumt,li) ilxturos In the dwelling and the first ( P 9 9 'Minimum permit fee Is$50+8%aurcharye,except Residential Backflow Prevention 100 feet of sanitary sewer storm sewer and water service) Device,which is$25+8%surcharge "Ali New Commerclal Buildings require plans with Isometric or riser diagram and plan review I is itslformiplumapp doc 1011199 L U rl E-,rl ;1 PLEASE COMPLETE: Fixture Type -- T--- — - - Quantity by Work Performed New Moved Replaced Removed/Capped Lavatory Tub or Tub/Shower Combination Shower Only —.— Water Closet Dishwasher Urinal_ Garbage Disposal Laundry Room Tray Washing Machine _ — Floor Drain/Floor Sink 2" Water Heater ___ _✓_ __ ✓�_ __ _ — Other Fixtures (Specify) _ COMMENTS REGARDING ABOVE: Imstaft mt0m sW doe IOil 0 CITY OF TIGARD `_ MECIiANICAI_PERMIT -� CITY TIG ARD SERVICES PERMIT#: MEC1999-00536 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/07/1999 PARCEL: 2S1 12BB-03500 SITE ADDRESS: 142:30 SW Y-IALL BLVD SUBDIVISION: WILSON ACRES ZONING: R-7 BLOC►:, LOT: 003 JURISDICTION: TIG CLASS OF WORK: AL f FLOOR FURN: EVAP COOLERS: TYPE OF USE: S1= UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENT 3 W/O APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS_ HOODS: FUEL TYPES i 0 3 HP: DOMES. INCIN: T _ J 3 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS FURN >=-100K BTU: <= 10000 cfm: � GAS OUTLETS: 1 > 10000 cfm: Remarks: Installation of a new gas furnace and gas piping. Owner: FEES WILSON BAISA, &TRACY Type By Date Amount Receipt 14230 SW HALL BLVD PRMT GEO 12/07/19E $50.00 99-320220 TIGARD, OR 97223 5PCT GEO 12/07/19E $4.00 99-320220 Total $54.OU Phone: -�- - Contractor: A-OK HEATING &AIR CONDITIONIN 19649 SW COLLINS RD NORTH PLAINS, OR 97133 REQUIRED INSPECTIONS___________ Gas Line Insp Phone:503-647-5531 Heating Lint Insp Reg#:LIC 105729 Final Inspection ORIGINAL This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-008 . You may obtain copi D� these rules or direct questions to OUNC by calling (50 )246-9189.r Issue By: Permittee Signature: eo— -- Call (56)639-4175 by 7:00 P.M. for inspections needed the next busin ss y Check# CITY OF TIGARD Mechanical Permit Application Read Plan Chehe 13115 SW FALL BLVD. Comrnercial and Residential Date Recd TIGARD, OR 97223 Date to P.E. (503) 639-4171, x304 Date to DST_ Print or Type Permit#Af`&/s�r9.O'�� G Incomplete or illegible applications will not be accepter.! Called Name of Deveioprnent/Projed Description Table 1A Mechanical Code Oty Price Amt .lobA Permit Fee _ Street Address SuRek 00 1) Furnace to 100,000 BTU 16. Address 142-,3, 05(.��_ including ducts&vents see footnote 1,2 9.65 Bldg# CRY/state Zip 2) Furnace 100,000 BTU+ TI GrAED u1Z q2 including ducts&vents see footnote 1,2 12.00 Name(or nameof bu iness) 3) Floor Furnace Owner W I L•50 �/ I�q ISA including vent _ see footnote 1,2 9.65 Melling Address 4) Suspended heater,wall healer t"L23y �� i51 floor mounted heater see footnote 1,2 _ .65 -1 vV 3)) Vent not included in a liani;e ermit 4.75 City/Slate Zip Phone Check all that apply: *Boller Heat Air TI AtT) 0,E17 For Items 6.10,see or Pump Cond Qty Price Amt Name(or name of buriness) footnotes 1,2 Com 6)<3HP;absorb unit to IL SUS/ S� 100K BTU 9.65 Occupant Mailing Address 7)3-15 HP;absorb unit 5 100k to 500k BTU 17.65 CRy/State Zip Phone 8)15-30 HP;absorb unit.5-1 mil BTU 24.15 Name - 9)30-50 HP;absorb Contractor ' L�A� unit 1-1.75 mil BTU 36.00 A -ole- ►7`��'�1I� `l- 10)>50HP;absorb unit Prior to permit MRing Address >1.75 mil BTU 60.15 _ issuance,a copy 110 L/ Al LA) C.9 LL tjs E-v 11 Air handling unit to 10,000 CFM of all licenses pilylState Zip Phone 7.00 are required H f / dR °nLj V ,5�01f 12)Air handling unit 10,000 CFM+ expired in COT Oregon Const Cont Board Lic 0 Ex . ate `I 11.85 _database !0.S "'(70 13)Nun-portable evaporate cooler Architect Name r ^' 7.00 14)Vent fan connected to a single duct Or Mailing Address 4.75 15)Ventilation system not included in appliance permit 1 7.00 Zip Phone Engineer �- � 16)Hood served by mechanical exhaust - 7.00 Describe work to be done. 17)Domestic incinerators 12.00 New O Repair O Replace with like kind Yes a No O 18)Commercial or Industrial type incinerator Residential 10 Commercial 48.25 19)Repair units Additional Information or description of work: 8.40 20)Wood stove/gas FP/other units/clothe dryerletc. 7.00 NOTE: For Commercial projects only;Units over 400 lbs require 21)Gas piping one to four outlets structural gas calcs See footnote 1 / 375 Type of fuel: oil O natural gas 0 LPG O electric O 22)More than 4-per outlet(each) 75 Minimum Permit Fee$50.00 SUBTOTAL I hereby acknowledge that I have read this application,that the Information 8%SURCHARGE given is correct,that I am the owner or authorized agent of PLAN REVIEW 25%OF SUBTOTAL Re ulred for ALL commercial rmits onl the owner,that plans submitted are In compliance with Oregon State laws. -�-•- 1�_.-� - - - TOTAL Signature of O erlAgent Date - ----- Other Inspections and Fees: 1. Inspections outside of normal business hours(mininum charge-two Contact Person Na a Phone hours) $50.00 per hour 4 _ 2. Inspections for which no fee Is specifically indicated (mbtimum M j U,y 5_�� charge-half hour) $50.00 per hour Foonotes for commercial projects only: 3. Additional plan review required by changes,additions or revisions to 1. Provide full schematic of existing and proposed gas line and pressure plans(minimum charge-one-half hour)$50.00 per hour 2. Provide drawings to scale showing existing and proposed mechanical units. `Stale Contractor Boiler Certification required "Residential AJC requires site plan showing placement of unit 1:lmechpenn.doc rev 7119/99 ,ALECTPICAL PERMIT #- ELC96--- 026 CITY OF TiGARD DATEPERMIT ISSUED: 01/106/96 COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd.Tigard,Oregon 97223@6199 (503)639.071 PAPCEL: S I TL, (iDL I " . . I, I SW HALL. Bi-1;. SUBDIVISION— . : WILSON ACRES 70NING: R--7 BI-OCK. . . . . . . . . . . L 0 T. . . . . . . . . . . . . s 3 Pro)ect Description: Install on e branch c i rci,,t i t. ------RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS-------- -------MISCELLANEOUS------- 1000 -J17 OR LESS. . . . s 0 0 2100 amp. . . . . . . : 0 PUMP/T RRIGA'r ION. . . . : 0 EACH ADD' L 500SF. . . 0 201 400 amp. . . . . . . : 0 SIGN/OUT LINE I-TG. . : 0 LIMITED ENERGY. . . . . : 0 401 600 amp. . . . . . . : 121 SIGNAL/r-ANEzi— . . . . . . -. 12) MANF. HM/ 13VC/FDP. . -. 171 6014-aMp5;-1000 volt S. : 0 MINOR L.ASFL. ( 10) . . . : IZA - ---GE7RVIC1-/FE1:-DER----,-- -BRANCH CIRCUITS----.-- --- -ADDIL. INSPECTIONS-- 0 i?00 amp. . . . . . : 0 W/SERVICE OR FEEDER: 121 PER INSPECTION— — : 0 ;'01 400 amp. . . . . . . 'A I st W,'f7 7,PVC OR FDR. : I PER HOUR. . . . . . . . . . . : 0 401 600 amp. . . . . . : 0 EA ADDIL BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0 C,IP 1 1.0 VI 0 ramp. . ,. . . : 'a ---- [',ILAN REVIEW 1000+ AMD/volt. . . . . : V, ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. Reconnect only. 1 0 SVC/FDR AMPS— : CLASS APPA/SPFC OCC- Owner,: FEES ------ ------ icn'' ou t 06amount by date rer-pt 14Z230 SW HALL BLVD PRmT s 35. 00 CJS 01/16/96 96--2749--- 3PCT $ 1. 75 CJS 01/16/96 9 2`74'-):x. TIGARD ON ")702,213 Phone #: Contractor.. MCCAL.L HEATING X rnOl-ING 36. 75 TOTAL 1650 NE LOMBARD REQUIRED INSPECTIONS PORTLAND OP 97211 Wal. ). Cover Flectil Fin;-i Phone #- rlect' l Service Rep ti,. . : This oersit is issuid subject to the regulations contained in the Tigard Municioal Code. State of Dre. Scenaltv Codes and all nthpr Permittee Sionat'.1re aaalicablp laws. All work will he cone in accor3ance with aoproved olans. This ptroit will oxoirt if work Is not started within 180 days of issuance. ;r if work is suspended for more than 181 days. lssl.ied By --.OWNr--'R I NGTAI-I.AT I ON, nNi r'.__....._,_..... ...._. _--.-----I.-..- The installation it-, beinp made on propprtv T riwn whir,h is riot intended for C'ale. leaso, or rent. OWNr-R1 S STGNATURE"t 1)A T F' ---------,CONTRAC.'roR INSTALLATION ONL'f ISIC-37NATURE OF SUPER. LLECI N: t1 DATE 16' L- ICENSE NO: Call for ins;pert inn i,,-,,c4.-4 L 75 Community Development ELECTRICAL PERMIT APPLICATIO14 13125 SW Hall Blvd. Tigard, OR 97223 Planck/Rec. # 96 ,� 7�IV3.,� .,�,. Permit # f�r7c> �7CLC Phone (503) 639-4171 Date Issued FAX (503) 684-7297 ------ Issued by 4,1 CITY OF TIGARD TDD No. (503) 684-2772 Inspection (503) 639-4175 1. Job Address: 4. Complete Fee Schedule. Below: Name of Development, _ RR _ Number of Inspections per permit allowed — Address /y z 3 O Lt 1 Vol Servtce included Items Cost(ea) Sum /State/Zi Ci ' .ty p_��A /�� U 7.Z 2 C 4s. Residential• par unit 4 t 1000 aq it or lew $11000 Name (or name of business) J,; is h f. C _ Each additional 500 aq It or �/ portion thereof V',00 Commercial❑ Residential E Limited Energy $;-,00 !� Each Menurd Home or Modular Dwelling Service or Feeder $66 00 2a. Contractor installation only: 4b. Services or Feeders Electrical Contractor J�' Installation,alteration,or relocation 2 GL�� r7F°C1Crr)c� t �[��1r/ 200 amps or lees $6000 2 Address �[y C /V L <: r77 rj c{/c" 201 amps to 400 avnpa $8000 2 ? 401 amps to 600 amps $120 00 2 C;Ity �( ! L IGL rlG '1, .Stater Zlp 1 7�) 601 amps to 1000 amps $16000 Phone No._2a I Over 1000 ampe or volts $34000 2 Contractor's License Na. �_ _ — y 1 / Peconnect only _� $5000 Contractor's Board Reg. No. - ZU 4c. Temporary Services or Feeders Installation.alteration.or relocation Signature of 5upr. Elec'n200 amps or lase $5000 License No. 1 -�.� /_ yj if hone No. ;, �. 3 3/ ;o, .mom�o soo n $Eco 00 __ ? Over 600 amps to 1000 Vohs 2b. For owner installations: ase•b•above 4d. Branch Circuits Print Owner's Name New,alteration or etrienston per panel Address e)The tee for brarrh crtcwlt with City State Zip_ purchase of"mice or llooder Phone No. �� Each branch circus $1,00 h)The fee for branch arcuaa without -rhe installation is being made on property I own which is purchase of swWee or feeder Me. _L_ -j not intended for sale, lease Or rent. fust branch circuit $35 00 ;I Each additional branch circuit $500 Owner's Signature___._________ 4e. Miscellaneous Plan or fonder not included) 3. Plan Review section (if required): Faeh pump cr irrigation arde $4000 1,ach sign or outline lighting $4000 _ signal citrus(s)or a Ivnrtad en9rgy Please check appropriate item and enter fee In section 50. panel aherewn or extension $4000 4 or more rHStdHntial units In one structure I Minor Iaholn(101 $10000 Servict,and feeder 225 amps or more System over 600 volts nominal 41. Each additional inspection over Classified area or structure containing special occupancy the allowable in any of the above as described in N.E.C. Chapter 5 Per uwpaclon _ $3500 Per hour _ $5500 � Submit 2 sets of plans with application where any of the above In Plant $55 00 ----- apply. Not required for temporary construction services. $. Fees: NOTICE 5s. Enter total of above fees $ 5%Surcharge(05 X total teen) $ _� r PERMITS BECOME VOID IF WORK OR CONSTRUCTION subtotal $ Vii, ,7 AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter 25%of line A for CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required(Sec 3) A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS subtotof $ COMMENCED. El Trust Account aY a Balance Due •aetYantNN�Mt-pm rpp CITY ME-CfAAN I CAL P E R 111 T OF TIGARD P1---RMIT #. . . . . . . : MFCgc,- 17100 COMMUNITY DEVELOPMENT DEPARTMENT DAT,= TriSUED: 01/16/96 13125 SW Hall Blvd.Tigard,Oregon 97223e8199 (503)639-4111 PARCEL: 2S11c"BEA-03500 )ITE ADDRESS. . . : 14230 5W HALL JALVD SUBDIVISION. . . . : WILSON ACRES ZONING: P-7 BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . ... CLASS OF WORV,. . :AL..T FLOOR FURN. . . . : 0 EVAP COOLERS- 0 TYPE OF USE. . . . SF UNIT HFATFRS. . 121, VENT FANS. . . : 0 XCUPANCY GRP. . :R3 VENTS W/O APPI 0 VENT f;YSTCMS)- 0 STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0 FUEL 0 -3 HP. . . . : 0 DOMES. INCTN: 0 /OIL/ 3-15 HP. . . . . 0 COMML.. INCIN: 0 i'.IX INPUT: 0 BTIJ 1!5-30 HP. . . . . 0 REPAIR UNITS: 0 [RE DAMPIERS". . . 30-50 HP. . . . : 0 WOODS70VES. . : 0 AS PRESSURE . : .50.4. HP. . . . : 0 ''L-0 DRYERS, 1. OF AIR HANDLING UNI'rs o'rHER UNITS. V1 1JrRN < 100K STU: 0 t= 10000 rfm : 0 GAS OUTLETS. 171 !RN BTU.- 1 > 10000 cfrn: 0 ?Mat•Pf' .- Resirlentiil rAlteration Of a oil 10011TU-+. Nner'l FEES I w*"FF ORI type amo�.tylt by date t'ecpt 4230 SW HALL BLVD rRM I' $ 5. 00 CJC; 01 /16,196 96—c"74034 D "P r T t I - --,5 1`775 01 /16/96 96-27ti ),34 GARD OR 471=.2':3 V —1 -one #. : 7 ritt-artoir,: V 0 .1 'CALL HCATINC-3 R. COOt-ING CO rWNW, ,50 NE LOMBARD JR71—AND OR 97i".11 iiorie #., a'-'31-3311 76. 75 TO'TAL 102030 REQUIRED INSVECTIONS This aersit is issued subiect to the regulations contained in the Mv0ianiral Irirn 'iwd Muricioal Code. State of Ore. Saecialty Codes and all other Misc'. Trisipecticin aDolicable laws. All work will be done in accordance with Final Iri!ippetiot) awraypd plans. This oermit will 4xcire if work is not started within 180 days of issuance. or if work is susBerided for more than 180 day;. t-M i t t G i tj ri'a t t-1 r e . lea' to v(j S V --5-e , a"/ I'A I I f o ion Uty of Tigard MECHANICAL PERMIT Planck/Rec. 's 7`��?!i 1312.5 sw Hall Blvd. APPLICATION Permit # 14, Tigard, OR 97223 (503) 639-4171 r oscnpuon Table 3A Mechanical Code CITY PRICE AMT Job Address ,,,. ✓ hl C' 1 VJ 1) PvFmit Fee _ -0 -0- 10,00 co 4.72 2 y 2) Supplemental Permit � ~«arm _�umace to 300 Adiw 1) Incl.duds b vents 6.00 Furnace too,0o0-ATQ;'— — Owner `W� r i t - _ 2) incl.duds d vents 7.50 •7 5 - F4) or or umance « .,. ...i wnt 6.00 pe atr(•wall oor mounted heater 600 Occupant t,or me-.in --) appliance permk _ 3.00 Repair of reabng,r iHr rig �� -- 6) cooling,absorption unit 6.00 i er or come, at purtT heat air cond. 4 iii F Q l J./r 7) to3 HP abs 1 1 a «. pwft __ I absorp 1 b 10BTU Bodee y or comp, at pump.air6.00 acond. Contractor C ( 5k MP 8) 3.15 HP absorp unit to 500K BTU 11.00 i er or comp,Ti—eat pump.air co ' r/ y i f 9) 1530 HP absorp unit.5-1 mil BTU 15.00 OM NYpn Y firer or ocxnp, at pump,air co - ' 10) 30.50 HP absorp unit 1-1.75 ml 81-U 22 50 hereby ac ow ge at have readis application,Mt teq— Boiler or comp, at Pump.air co information given is correct,that 1 am the owner or authorized agent 1 1) >50 HP absorp ul*t 1.75 mil BTU of the owner,that plans submitted are in compliance with State _ 31.50 laws,that I am registered with the Construction Contn�s Board, � Au andluna to - - that the number given Is correct (if exempt trom State registration, 12) 10,000 CFM _— 450 please give reason below.) r an 'n9—,,nt 13) 10,000 CTM♦ 7.50 len portab o 14) Pvaporate cooler 4.50 entan connect ---- 15) to a single dud 3.00 enn anon system not 16) included in appliance permit 450 •nww a ywry W .__ Hood sery -- 17) mechanical exhaust 450 scn w new a itron a terabon repair mmercta or stns to be done residontial non-residential Q Existing use n i18) type Irator 30.00 ter .e., stove,water building or property 19) heater,solar,clothes dryers,etc. 450 Proposed use of 20) Gas piping one to four outlets building or property 2,00 Type of fuel-of q natural gas 0 LPG Q electric O 21) More than 4-per outlet NOtICE PERMITS BECOME'!OID IF WORK OR CONSTRUCTION Minimum Fee$25m SUBTOTAL AUTHORIZED IS NOT COMMENCED WITHIN 160 DAYS,OR sX SURCHARGE IF CONSTRUCTION OR WORK IS SUSPENDED OR _ ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PLAN REVIEW 25X OF SUBTOTAL Special Conditions TOTAL Jam, 5 Date issued�_ jld by_ G ��Eu�r►nr wdornd..